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Cancer Issues Author: Staff Editor Last Updated: Sep 7, 2017 - 10:06:33 PM



Patient Selection Key to Successful Immunotherapy

By Staff Editor
Jun 22, 2017 - 8:13:48 AM



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(HealthNewsDigest.com) - Immunotherapy using anti-PD-1 antibodies has revolutionized the treatment of non-small cell lung cancer (NSCLC) and a growing list of other cancers. The most widely used of this new class of drugs are pembrolizumab and nivolumab, which have shown tremendous success in extending survival in people with NSCLC compared to traditional treatments such as chemotherapy.

Dr. Edward Garon
However, a pair of recent studies published in the  New England Journal of Medicine comparing the two drugs to chemotherapy in patients enrolled in clinical trials with  higher levels of a certain protein showed different results in terms of their effectiveness.  Pembrolizumab was found superior to chemotherapy in one clinical trial, while nivolumab was not superior to chemotherapy in the other trial, which led to some confusion among treating oncologists.

There is a great deal of debate as to the extent to which effectiveness of pembrolizumab and nivolumab are dependent upon the expression levels of a biomarker known as PD-L1. Dr. Edward Garon is the director of the Thoracic Oncology Program at UCLA and a member of UCLA's Jonsson Comprehensive Cancer Center. His groundbreaking research laid the foundation for the FDA to approve pembrolizumab (marketed as Keytruda) as well as a companion diagnostic assay to assess PD-L1 to select patients most likely to benefit from pembrolizumab.

Along with the study on nivolumab versus chemotherapy, the New England Journal of Medicine published an editorial that Garon authored to address the contrasting results of the two studies. In the editorial, Garon argued that superior ability of the pembrolizumab trial to select the appropriate patient population based on tumor PD-L1 expression likely led to the disparate results. He concluded that tumor PD-L1 expression should be assessed in all advanced non-small cell lung cancer patients with the assay that was used in the pembrolizumab clinical trials based on its proven clinical value.

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